Equis ISSN 2398-2977

Surgery: suture patterns - hollow organs

Contributor(s): Stephen Adams, Debbie Archer, Graham Munroe

General principles

  • Must be placed with great care, particularly in the gastrointestinal (GI) tract because of the problems of leakage.
  • Generally heal quite quickly and immediate sealing by a fibrin clot means that appositional sutures can be used as an alternative to inverting suture patterns.

Everting suture patterns are not recommended due to poor healing and increased incidence of adhesions.

  • The health of the walls of the organ will determine the ease of suturing and viability of repair, eg friable uterus in Cesarean section   Uterus: caesarean section  with decomposing fetus.
  • The strength of the repair depends upon the use of the fibromuscular layer or submucosa.
  • In general, synthetic absorbable suture materials are used   Surgery: suture materials - overview  , swaged onto a round-bodied needle.
  • Interrupted sutures are safer, allow individual adjustment of suture tension but take longer   Surgery: suture patterns - overview  .
  • Continuous sutures are rapid, but can compromise the wound edges and are not as safe as interrupted sutures.

Lembert and Halsted sutures

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Cushing and Connell Sutures

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Parker-Kerr Oversew and Purse String Sutures

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Gambee Suture

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